Training

NANCY CLARK: Quick Injury Recovery

The Athlete’s Kitchen

Copyright: Nancy Clark MS RD CSSD Jan 2013

Injured Runners: Nutrition Tips to Hasten Healing

Being injured is one of the hardest parts of being a runner. If you are unable to exercise due to broken bones, knee surgery, stress fracture, or tendonitis, you may wonder: What can I eat to heal quickly? How can I avoid getting fat while I'm unable to run? Should I be taking supplements? This article will address those concerns, plus more.

Don’t treat good nutrition like a fire engine

To start, I offer this motherly reminder: Rather than shaping up your diet when you get injured, strive to maintain a high quality food intake every day. That way, you'll have a hefty bank account of vitamins and minerals stored in your liver, ready and waiting to be put into action. For example, a well-nourished runner has enough vitamin C (important for healing) stored in the liver to last for about six weeks. The junk food junkie who gets a serious sports injury (think bike crash, ACL repair, or even car accident) and ends up in the hospital has a big disadvantage. Eat smart every day!

Don’t diet

A big barrier to optimal fueling for injured runners is fear of getting fat. Please remember: even injured runners need to eat! I've had a marathoner hobble into my office on crutches saying, “I haven't eaten in three days because I can't run.” He seemed to think he only deserved to eat if he could burn off calories with purposeful exercise. Wrong! Another athlete lost her appetite after having foot surgery. While part of her brain thought “what a great way to lose weight,” her healthier self realized that good nutrition would enhance recovery.

Despite popular belief, your organs (brain, liver, lungs, kidneys, heart, etc.)—not exercising muscles—burn the majority of the calories you eat. Organs are metabolically active and require a lot of fuel. About two-thirds of the calories consumed by the average (lightly active) person support the resting metabolic rate (the energy needed to simply exist). On top of that, your body can require 10% to 20% more calories with trauma or minor surgery; major surgery requires much more. Yes, you may need fewer total calories because you are not training hard, but you definitely need more than your sedentary baseline. Your body is your best calorie counter, so respond appropriately to your hunger cues. Eat when hungry and stop when your stomach feels content.

Here are two other weight myths, debunked:

Muscle turns into fat. Wrong. If you are unable to exercise, your muscles will shrink, but they will not turn into fat. Wayne, a skier who broke his leg, was shocked to see how scrawny his leg muscles looked when the doctor removed the cast six weeks later. Once he started exercising, he rebuilt the muscles to their original size.

Lack of exercise means you'll get fat. Wrong. If you overeat while you are injured (as can easily happen if you are bored or depressed), you can indeed easily get fat. Joseph, a frustrated football player with a bad concussion, quickly gained 15 pounds post-injury because he continued to eat lumberjack portions. But if you eat mindfully, your body can regulate a proper intake. Before diving into meals and snacks, ask yourself, “How much of this fuel does my body actually need?”

When injured, some underweight runners gain to their genetic weight. For example, Jessica, a 15-year-old high school runner, perceived her body was “getting fat” while she recuperated from a knee injury. She was simply catching up and attaining the physique appropriate for her age and genetics.

Do eat “clean”

To enhance healing, you want to choose a variety of quality foods that supply the plethora of nutrients your body needs to function and heal. Don't eliminate food groups; they all work together synergistically! Offer your body:

Carbohydrates from grains, fruits, vegetables. By having carbs for fuel, the protein you eat can be used to heal and repair muscles. If you eat too few carbs—and too few calories, your body will burn protein for fuel. That hinders healing.

Protein from lean meats, legumes, nuts and lowfat dairy. Protein digests into the amino acids needed to repair damaged muscles; your body needs a steady stream of amino acids to promote healing (especially after physical therapy). You need extra protein post-injury or surgery, so be sure to include 20 to 30 grams of protein at each meal and snack. A portion with 20 to 30 grams of protein equates to one of these: 3 eggs, 1 cup cottage cheese, 3 to 4 ounces of meat, poultry, or fish, two-thirds of a 14-ounce cake of firm tofu, or 1.25 cups of hummus. While you might see ads for amino acid supplements including arginine, ornithine, and glutamine, you can get those amino acids via food.

Plant and fish oils. The fats in olive and canola oils, peanut butter, nuts and other nut butters, ground flaxseeds, flax oil, and avocado have an anti-inflammatory effect. So do omega-3 fish oils. Eat at least two or three fish meals per week, preferably the oilier fish such as Pacific salmon, barramundi, and albacore tuna. Reduce your intake of the omega-6 fats in packaged foods with “partially hydrogenated oils” listed among the ingredients, and in processed foods containing corn, sunflower, safflower, cottonseed, and soy oils. Too much of these might contribute to inflammation.

Vitamins. By consuming a strong intake of colorful fruits and vegetables, you'll get more nutrition than in a vitamin pill. Fruits and veggies have powerful anti-oxidants that knock down inflammation. Don’t underestimate the healing powers of blueberries, strawberries, carrots, broccoli, and pineapple. Make smoothies using tart cherry juice, PomWonderful pomegranate juice, and grape juice.

Minerals. Many runners, particularly those who eat little or no red meat, might need a boost of iron. Blood tests for serum ferritin can determine if your iron stores are low. If they are, your doctor will prescribe an iron supplement. You might also want a little extra zinc (10 to 15 mg) to enhance healing.

Herbs, spices and botanicals. Anti-inflammatory compounds are in turmeric (a spice used in curry), garlic, cocoa, green tea, and most plant foods, including fruits, vegetables, and whole grains. For therapeutic doses of herbs and spices, you likely want to take them in pill-form. Yet, consuming these herbs and spices on a daily basis, in sickness and in health, lays a strong foundation for a quick recovery.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her Sports Nutrition Guidebook and food guides for new runners, marathoners, and cyclists offer additional information. They are available at www.nancyclarkrd.com. See also sportsnutritionworkshop.com.